CDPH in the News, January 2017

CDPH in the News

California Department of Public Health (CDPH) State Public Health Officer Dr. Karen Smith reported today that the state is experiencing widespread influenza activity that is more severe than last year due to significantly higher numbers of hospitalizations and outbreaks throughout the state. CDPH has also received the first report of a death associated with influenza in a child younger than 18 years of age. The death occurred in Riverside County. "This is a tragic reminder that the flu is a serious illness for people of all ages and kills thousands of Americans each year," said Dr. Smith. "If you haven’t been immunized yet this season, getting flu shots for you and your family now can still help protect you this winter."
Since the beginning of the influenza season, CDPH has received reports of 14 influenza-associated deaths, including the child in Riverside. This count represents a fraction of the total flu deaths statewide because only deaths in people younger than 65 are reported to the state and not all influenza-related deaths are easily attributable to influenza.
Hospitals statewide have been impacted by a surge in influenza patients, and hospitalizations for pneumonia and influenza at Kaiser Permanente hospitals in Northern California during the week ending January 7 reached 10.2 percent, the highest level recorded in 10 years. CDPH has also received reports of 83 influenza outbreaks, mostly in long-term care facilities, more than twice the reports received in recent years.

Los Angeles County’s public health department said Friday that it has confirmed two more measles cases, bringing to nine the number it has identified in the outbreak that it says began a month ago.
So why does such a small number of cases constitute an outbreak?
Public Health says it declared an outbreak because “the number of cases is definitely greater than expected and the majority of confirmed cases are epidemiologically linked.” The criteria for defining an outbreak depend on the particular disease. For “uncommon conditions,” the department says, an outbreak could be “two or more cases that are connected by social, environmental or geographical circumstance.”
While the department says there have been sporadic cases in the past 20 months, this is the first measles outbreak in L.A. County since the one that began at the Disney theme parks in Dec. 2014. By the time that outbreak was contained in April 2015, the California Department of Public Health had confirmed 136 cases statewide.

Researchers have sequenced and analyzed genomes from Shigella sonnei bacteria associated with major shigellosis outbreaks in California in 2014 and 2015. Shigellosis causes abdominal pain, diarrhea and other gastrointestinal problems and results in roughly 500,000 infections, 6,000 hospitalizations and 70 deaths in the United States each year.
A team from UC Davis and the California Department of Public Health conducted the first major whole-genome study of S. sonnei strains in North America to gain insight into how the bacteria acquired virulence and antibiotic resistance, and to show the California strains’ relationship to other strains throughout the world.

California SNF fined $100k over safety violations that led to patient’s death

The State of California has fined Laguna Honda Hospital and Rehabilitation Center, a skilled nursing facility in San Francisco, $100,000 after an investigation by the California Department of Public Health found safety violations that were a proximate cause of a patient’s death.
The safety violations occurred Nov. 26, 2014. According to the investigation report, a nurse assistant failed to lock both wheels of a patient’s wheelchair while on an outing to a movie theater and then left the patient unattended. The wheelchair rolled off the curb and the patient landed face-first on the ground. The patient, who had dementia and other chronic conditions, suffered severe injuries, including a face laceration, hip fractures and internal head bleeding, and died Dec. 10, 2014. According to the California Department of Public Health, $100,000 is the maximum fine state regulators can impose under state law.

California hospitals with high rates of HAIs have not been inspected in years, investigation finds

While California law requires hospitals to be inspected every three years, 131 hospitals in the state have not been inspected in five years, and 80 of those hospitals have high rates of hospital-acquired infections, according to a petition filed by Consumers Union covered by the Los Angeles Times.
California does not require hospitals to report patient infections with certain rare superbugs nor does it require these facilities to report deaths resulting from HAIs. In order to identify hospitals in the state with troubling infection patterns, the national nonprofit Consumers Union looked at rates of a few HAIs that must be reported under a 2008 law. The pathogens included in the nonprofits analysis were methicillin-resistant Staphylococcus aureus and Clostridium difficile. While Consumers Union said the data is not comprehensive, it has revealed which hospitals have struggled with controlling infections.
“It’s time to start looking at these hospitals that have significantly higher infection rates and do something that makes them accountable,” said Lisa McGiffert, director of Consumers Union’s Safe Patient Project, according to the LA Times. The petition requests the state investigate hospitals with high infection rates and enforce penalties for safety violations. The state must either respond to the petition in writing or hold a public hearing on the matter. According to the LA Times, the California Department of Public Health said it would respond within 30 days.